DR. MADHUR MITTAL (NPI# 1932153673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932153673 |
| Entity Type | Individual |
| Full Name | DR. MADHUR MITTAL |
| Credential | MD |
| Practice Address |
118 Memorial Dr Jacksonville NC 28546-6328 |
| Practice Telephone | 9103530581 |
| Practice Fax Number | 9105771150 |
| Mailing Telephone | 9103530581 |
| Mailing Fax Number | 9109394269 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
9700337 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8910650 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 120 Memorial Dr, Jacksonville, NC 285466328 | 9103530581 | 9103531351 |
| 3221 Henderson Dr, Jacksonville, NC 285465251 | 9102198326 | 9109394269 |
| Street Address |
118 MEMORIAL DR |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073513875 | Anna Skaskiw | Pediatrics | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2005-07-22 |
| 1174151658 | Samantha Ruth Ferguson | Nurse Practitioner | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2020-03-30 |
| 1245862424 | Jordan Kate Mccormick | Nurse Practitioner | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2020-02-06 |
| 1609435684 | Katie Lynn Hill | Nurse Practitioner | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2019-06-12 |
| 1699274050 | Marsha Currin Hull | Nurse Practitioner | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2018-02-12 |
| 1992125322 | Duy An Tran Minior | Pediatrics | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2014-04-24 |
| 1447587423 | Lindsey Boxxe Fiacco | Pediatrics | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2009-11-11 |
| 1669592457 | Kimberly A Lewis | Physician Assistant | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2007-03-29 |
| 1164519070 | Jacksonville Children's and Multispecialty Clinic, Pa | Allergy & Immunology | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2006-10-10 |
| 1447361480 | Arnold Camacho Olegario | Pediatrics | 118 Memorial Dr, Jacksonville, NC 28546-6328 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447209333 | Deborah Donlon | Pediatrics | 653-1 W 8th St # L16, Lrc, 3rd Floor, Jacksonville, FL 32209-6511 | 2006-05-08 |
| 1417266081 | Sfurti Nath | Pediatrics | 655 W 8th St, C-3, Jacksonville, FL 32209-6511 | 2010-09-30 |
| 1326368051 | Coastal Childrens Services, Pllc | Pediatrics | 317 Western Blvd, Jacksonville, NC 28546-6338 | 2010-06-04 |
| 1225358179 | Shalinkumar Pradipbhai Patel | Pediatrics | 655 W 8th St, Jacksonville, FL 32209-6511 | 2010-06-02 |
| 1770712390 | Sanket D Shah | Pediatrics | 653-1 W 8th St, Jacksonville, FL 32209-6511 | 2009-07-02 |
| 1922172691 | Catherine E Tsai | Pediatrics | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2006-11-17 |
| 1013929579 | Cynthia Marie Schultz | Pediatrics | 554 Keily Street, Bumed Centralized Credential and Privileging Direct, Jacksonville, FL 32212 | 2006-08-13 |
| 1235195272 | Mae M Coleman | Pediatrics | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2006-04-26 |
| 1821055633 | Arthur James Vaughn | Pediatrics | 4205 Belfort Rd, #4090, Jacksonville, FL 32216-1471 | 2006-04-26 |
| 1033172523 | Ronald P Carzoli Jr. | Pediatrics | 1800 Barrs St, St Vincent's Medical Center, Jacksonville, FL 32204-4704 | 2006-04-07 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.